Groin Pain

I have pain in my groin. Could it be a hernia?

Usually, a hernia becomes noticeable as a lump or swelling in the groin. But, what if you have pain in the groin but no swelling? Could the pain be caused by a hernia that is too small to be seen or felt? This is a difficult problem. Groin pain can be caused by several conditions of the muscles and bones in and around the groin. A hernia is one amongst many other possible causes for groin pain.

What test should I have for groin pain?

An ultrasound scan usually is the first test for groin pain. But, ultrasound scanning is not always accurate. Studies have shown that hernias are actually found at operation in only 50-75% of patients in whom the scan had shown a hernia. Also, ultrasound scan may not pick up causes of groin pain other than a hernia.

Will hernia surgery improve groin pain?

An ultrasound scan may show a small hernia in some people with groin pain. The question is whether this small hernia is actually the cause of the pain. Or, is it just an incidental finding and the pain is caused by something else? The treatment for a hernia is an operation. But, if the hernia is not causing pain then an operation is unnecessary. Although a hernia operation is simple, it does carry risks and it should not be taken lightly. There is no clear scientific guidance on this subject. The options are to do a hernia operation or to wait and watch or to see a specialist in muscle, bone and joint problems. The decision will depend on your individual circumstances.

What is a Sportsman’s hernia?

Groin pain can be a problem for athletes and active sportspersons. Groin pain seems to be more common with sports that involve twisting, turning, sprinting and kicking activities. The exact cause of groin pain in sportspersons is unclear. The pain may be caused by strain in the ligaments that are attached to the pubic tubercle (a part of the pelvic bone in the groin). There may weakness of the posterior wall of the inguinal canal and tears in the aponeurosis of the external oblique muscle. The condition is also called sportsman’s groin, groin muscle strain and inguinal disruption.

What is the treatment for a Sportsman’s hernia?

Physiotherapy and active sports rehabilitation are important. Also, it may be helpful to see an orthopaedic specialist to rule out any bone or joint problem. Careful consideration should be given to an operation if there is no improvement with non-surgical treatment. There is no standard operation for this condition. Various procedures have been described. Basically, the operation is the same as that for an inguinal hernia. Mr Sarela uses the laparoscopic totally extraperitoneal (TEP) method, which is recommended by experts.